Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
1
Application Form
In order for us to complete the application assessment administrative requirements, including those required in order to comply
with UK anti-money laundering rules and regulations, we will complete checks electronically wherever possible in order to minimise
the time it takes to complete our assessment of your application. In certain circumstances, however, it may be necessary to request
additional information or documentation, which may need to be certied.
Application Details
DIP Ref. No:
Conrmed on your initial agreement
Applicant Name 1: Applicant Name 2:
Limited Company (if applicable): LLP Name (if applicable):
Company Number:
Trust or Partnership Details (if applicable)
Full Name of Trust: Date of Partnership or Trust Deed
D M YD M Y
List of Directors, Partners, Trustees or Equivalent (list all)
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Name: % of Shares (or equivalent) Held:
Where the names, residential addresses (for the last 3 years), nationality and dates of birth of the above-named directors,
partners, trustees (or equivalent) are not a matter of public record, please supply this information with this form.
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
2
Employment Details Employment Details
Applicant 1 Applicant 2
First Name: First Name:
Surname: Surname:
Employed
Self-employed Unemployed Retired
Employed
Self-employed Unemployed Retired
Employer or Business Name: Employer or Business Name:
Occupation/Sector: Occupation/Sector:
Business Address: Business Address:
Postcode: Postcode:
Employment Start Date:
D M YD M Y
Employment Start Date:
D M YD M Y
Basic Gross Income (PA): £ Basic Gross Income (PA): £
Other Gross Income (PA): £ Other Gross Income (PA): £
Please specify other income: Please specify other income:
National Insurance No:
National Insurance No:
If less than 12 months at current employment please complete
the following:
If less than 12 months at current employment please complete
the following:
Former Employer: Former Employer:
Occupation/Sector: Occupation/Sector:
Employment Start Date:
D M YD M Y
Employment Start Date:
D M YD M Y
Employment End Date:
D M YD M Y
Employment End Date:
D M YD M Y
How was your wealth accumulated – please provide detailed explanation
Applicant 1 Applicant 2
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
3
Credit Commitments
Applicant 1
(these include Switch/Visa Debit card/Mastercard/Amex/Diners cards/
store cards/other cards/current accounts/bank loans/other loans/savings
accounts/secured loans)
Applicant 2
(these include Switch/Visa Debit card/Mastercard/Amex/Diners cards/
store cards/other cards/current accounts/bank loans/other loans/savings
accounts/secured loans)
Commitment 1: Commitment 1:
Type of Commitment: Type of Commitment:
Name the Commitment is in: Name the Commitment is in:
Name of Lender/Company: Name of Lender/Company:
End Date of Loan:
D M YD M Y
End Date of Loan:
D M YD M Y
Monthly Repayment: £ Monthly Repayment: £
Balance Outstanding: £ Balance Outstanding: £
Paid on Completion?
Y N
Paid on Completion?
Y N
Commitment 2: Commitment 2:
Type of Commitment: Type of Commitment:
Name the Commitment is in: Name the Commitment is in:
Name of Lender/Company: Name of Lender/Company:
End Date of Loan:
D M YD M Y
End Date of Loan:
D M YD M Y
Monthly Repayment: £ Monthly Repayment: £
Balance Outstanding: £ Balance Outstanding: £
Paid on Completion?
Y N
Paid on Completion?
Y N
Commitment 3: Commitment 3:
Type of Commitment: Type of Commitment:
Name the Commitment is in: Name the Commitment is in:
Name of Lender/Company: Name of Lender/Company:
End Date of Loan:
D M YD M Y
End Date of Loan:
D M YD M Y
Monthly Repayment: £ Monthly Repayment: £
Balance Outstanding: £ Balance Outstanding: £
Paid on Completion?
Y N
Paid on Completion?
Y N
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
4
Credit Commitments (cont.)
Applicant 1 Applicant 2
Commitment 4: Commitment 4:
Type of Commitment: Type of Commitment:
Name the Commitment is in: Name the Commitment is in:
Name of Lender/Company: Name of Lender/Company:
End Date of Loan:
D M YD M Y
End Date of Loan:
D M YD M Y
Monthly Repayment: £ Monthly Repayment: £
Balance Outstanding: £ Balance Outstanding: £
Paid on Completion?
Y N
Paid on Completion?
Y N
Commitment 5: Commitment 5:
Type of Commitment: Type of Commitment:
Name the Commitment is in: Name the Commitment is in:
Name of Lender/Company: Name of Lender/Company:
End Date of Loan:
D M YD M Y
End Date of Loan:
D M YD M Y
Monthly Repayment: £ Monthly Repayment: £
Balance Outstanding: £ Balance Outstanding: £
Paid on Completion?
Y N
Paid on Completion?
Y N
Other Outgoings: Other Outgoings:
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
5
Personal Monthly Commitments
Applicant 1 Applicant 2 Joint
Electricity £ £ £
Gas: £ £ £
Water: £ £ £
Telephone: £ £ £
Food: £ £ £
Child Care: £ £ £
Fuel: £ £ £
Insurance: £ £ £
Social: £ £ £
Clothing: £ £ £
Other Regular Expenses: £ £ £
Total of all Commitments: £ £ £
Accountant’s Details
Company Name: Accountant’s Name:
Telephone: Email:
Address:
Postcode:
0.00
0.00
0.00
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
6
Solicitor’s Details
Purchase Application:
Would you like an HTB Solicitor to provide representation?
Y N
If no, please provide details of your nominated Solicitor:
Company Name: Solicitor’s Name:
Telephone: Email:
Address:
Postcode:
Broker Fee Deduction
By signing this declaration you acknowledge that we will pay the fee detailed below directly to your mortgage broker
on completion. The broker fee will be deducted from the Net mortgage advance.
Broker/Intermediary Name: A Fee Amounting to: £
Your broker will be acting as your agent. If your broker is not the intermediary who submitted the application to Hampshire Trust
Bank Plc, we will pay any broker fee to the submitting intermediary and not direct to your broker. It is not a condition of the
advance that any broker fees are payable and any broker fee is a matter for agreement between you and your broker.
News and Marketing
We will never share your information with third parties for marketing purposes. We will never send you marketing about products
or services from third parties. We would like to send you news and other information about us, our products and our services.
Please tick the boxes below showing how you would like to receive this. If you change your mind at any time then let us know and
we will update your preferences. We will use your contact details that you or your broker provided to us in the Decision in Principle
Proposal Form – however you may provide us with dierent contact details at any time.
For Individual Borrowers For Companies, LLPs, SIPPs, Trusts and other Borrowers
Applicant 1 Applicant 2
e-mail
e-mail
e-mail
telephone
telephone
telephone
post
post
post
text message
text message
text message
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
7
Declaration
Please note that it is a criminal oence to knowingly or recklessly give false, inaccurate or misleading information when applying
for a loan. If you provide such information, you may be reported to the police and prosecuted. As a responsible lender Hampshire
Trust Bank Plc will carefully assess the information you have provided or which has been provided by your agent whether in the
application form or in other correspondence, emails and conversations, in order to decide whether or not to make you an oer
of a Loan. It is important you ensure that all statements you make in this form and other documents in connection with your
application are full and accurate and are correct and that you have read and understood the contents of this declaration.
Please be aware that in processing your application, Hampshire Trust Bank Plc may share your information with parties
with whom the bank has a contractual relationship, to facilitate making a credit decision.
I/We authorise Hampshire Trust Bank Plc (the “Bank”) to:
(a)
make such enquiries of any person or organisation (including my/our existing or previous mortgage lenders),
as the Bank considers necessary inconnection with this application; and
(b)
give out information about me/us if you have a duty to do so or if law allows you to do so.
I/We understand that if I/We give the Bank false or incomplete information and the Bank suspects fraud, then the Bank will
record this and notify such parties as is necessary for the Bank to comply with its legal and regulatory responsibilities; and
I/We authorise our solicitors or licensed conveyancer acting on my/our behalf to disclose to the Bank or its solicitor, and
conrm that the Bank is authorised to disclose to my/our solicitors or licensed conveyancer, any information relating to this
application, and
I/We conrm that I/We waive or give up any right to claim solicitor/client condentiality or legal privilege in respect of such
information; and
I/We acknowledge and understand that the Bank, as a responsible lender, will take a proactive approach to ensuring that
appropriate action is taken to prevent arrears from becoming unmanageable; and
I/We acknowledge and understand that the Bank needs to be able to contact some or all of the following in connection with
any Loan that I/We may have with the Bank, or any potential loan that I/we have applied for with the Bank, namely: my/our
solicitors, (where appropriate) the intermediary who introduced me/our Loan to the Bank and the insurance company(ies)
that has/have insured the property(ies) that I/We have provided to the Bank as security for my/our Loan or potential loan.
Accordingly, I/We irrevocably conrm that until our Loan has been repaid in full, the Bank and it’s successors and assigns may
contact and disclose to any of the above mentioned person(s) or organisation(s) as they may consider reasonably necessary
and request from such person(s) or organisations in dealing with the repayment or renance of my/our Loan(s) with the Bank
and/or in connection with the insurance of the property(ies) which comprises the Bank’s security.
By signing this Form, I/We conrm that the information provided is true, accurate and correct and I/We declare that the
information relating to my/our income and outgoings and assets and liabilities is true and accurate and that I/We am/are
nancially able to meet all my/our nancial commitments including any interest payments I/We will be required to make on
my/our Loan.
I/We acknowledge having received and read a copy of the Fair Processing Notice and Credit Reference Agency Information
Notice that was provided to me/us at the time that we completed the Decision in Principle Proposal Form and that I/We
understand the basis upon which my/our information will be used and shared and that I/We are satised to proceed with
this application.
Hampshire Trust Bank Plc is authorised by the Prudential Regulation Authority and regulated by the Prudential Regulation Authority and the Financial Conduct Authority.
Our FRN number is 204601. We are a company registered in England and Wales, registration number 01311315. Registered oce 55 Bishopsgate, London EC2N 3AS.
Hampshire Trust Bank, HTB and
are registered trademarks of Hampshire Trust Bank Plc.
April 2019
Specialist
Mortgages
8
Declaration (cont.)
Applicant 1 Applicant 2
Borrower/Director Signature: Borrower/Director Signature:
Print Name: Print Name:
Company Name: Company Name:
Date of Signature:
D M YD M Y
Date of Signature:
D M YD M Y
Please note that in order to fully progress this application, we require you to complete and provide all of the information as detailed in the Decision in Principle previously provided.
click to sign
signature
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click to sign
signature
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